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  1. Article ; Online: Response by Bularga et al to Letter Regarding Article, "Coronary Artery and Cardiac Disease in Patients With Type 2 Myocardial Infarction: A Prospective Cohort Study".

    Bularga, Anda / Mills, Nicholas L / Chapman, Andrew R

    Circulation

    2022  Volume 146, Issue 19, Page(s) e258–e259

    MeSH term(s) Humans ; Prospective Studies ; Myocardial Infarction/diagnosis ; Coronary Artery Disease ; Anterior Wall Myocardial Infarction ; Heart Diseases
    Language English
    Publishing date 2022-11-07
    Publishing country United States
    Document type Letter ; Research Support, Non-U.S. Gov't ; Comment
    ZDB-ID 80099-5
    ISSN 1524-4539 ; 0009-7322 ; 0069-4193 ; 0065-8499
    ISSN (online) 1524-4539
    ISSN 0009-7322 ; 0069-4193 ; 0065-8499
    DOI 10.1161/CIRCULATIONAHA.122.061692
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Not to be sneezed at: cardiovascular disease after COVID-19 infection.

    Bularga, Anda / Newby, David E / Chapman, Andrew R

    Heart (British Cardiac Society)

    2022  Volume 109, Issue 2, Page(s) 84–85

    MeSH term(s) Humans ; Cardiovascular Diseases/diagnosis ; Cardiovascular Diseases/epidemiology ; Cardiovascular Diseases/etiology ; COVID-19 ; Stroke ; Risk Factors ; Atrial Fibrillation ; Heart Failure ; Anticoagulants
    Chemical Substances Anticoagulants
    Language English
    Publishing date 2022-12-22
    Publishing country England
    Document type Editorial ; Research Support, Non-U.S. Gov't ; Comment
    ZDB-ID 1303417-0
    ISSN 1468-201X ; 1355-6037
    ISSN (online) 1468-201X
    ISSN 1355-6037
    DOI 10.1136/heartjnl-2022-321748
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Mechanisms of Myocardial Injury in COVID-19.

    Bularga, Anda / Chapman, Andrew R / Mills, Nicholas L

    Clinical chemistry

    2021  Volume 67, Issue 8, Page(s) 1044–1046

    MeSH term(s) COVID-19 ; Heart Injuries ; Humans ; SARS-CoV-2 ; Troponin I
    Chemical Substances Troponin I
    Language English
    Publishing date 2021-06-08
    Publishing country England
    Document type Editorial ; Research Support, Non-U.S. Gov't ; Comment
    ZDB-ID 80102-1
    ISSN 1530-8561 ; 0009-9147
    ISSN (online) 1530-8561
    ISSN 0009-9147
    DOI 10.1093/clinchem/hvab111
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  4. Article ; Online: High-Sensitivity Cardiac Troponin Can Be an Ally in the Fight Against COVID-19.

    Chapman, Andrew R / Bularga, Anda / Mills, Nicholas L

    Circulation

    2020  Volume 141, Issue 22, Page(s) 1733–1735

    MeSH term(s) Acute Kidney Injury/diagnosis ; Acute Kidney Injury/etiology ; Betacoronavirus/isolation & purification ; COVID-19 ; Coronavirus Infections/complications ; Coronavirus Infections/pathology ; Coronavirus Infections/virology ; Fibrin Fibrinogen Degradation Products/analysis ; Humans ; Lymphocyte Count ; Myocardial Infarction/diagnosis ; Myocardial Infarction/etiology ; Myocardium/metabolism ; Pandemics ; Pneumonia, Viral/complications ; Pneumonia, Viral/pathology ; Pneumonia, Viral/virology ; Proportional Hazards Models ; Respiratory Distress Syndrome/diagnosis ; Respiratory Distress Syndrome/etiology ; SARS-CoV-2 ; Troponin I/analysis
    Chemical Substances Fibrin Fibrinogen Degradation Products ; Troponin I ; fibrin fragment D
    Keywords covid19
    Language English
    Publishing date 2020-04-06
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 80099-5
    ISSN 1524-4539 ; 0009-7322 ; 0069-4193 ; 0065-8499
    ISSN (online) 1524-4539
    ISSN 0009-7322 ; 0069-4193 ; 0065-8499
    DOI 10.1161/CIRCULATIONAHA.120.047008
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Computed tomography coronary angiography in non-ST-segment elevation myocardial infarction.

    Wang, Kang-Ling / Meah, Mohammed N / Bularga, Anda / Singh, Trisha / Williams, Michelle C / Newby, David E

    The British journal of radiology

    2022  Volume 95, Issue 1140, Page(s) 20220346

    Abstract: Electrocardiography and high-sensitivity cardiac troponin testing are routinely applied as the initial step for clinical evaluation of patients with suspected non-ST-segment elevation myocardial infarction. Once diagnosed, patients with non-ST-segment ... ...

    Abstract Electrocardiography and high-sensitivity cardiac troponin testing are routinely applied as the initial step for clinical evaluation of patients with suspected non-ST-segment elevation myocardial infarction. Once diagnosed, patients with non-ST-segment elevation myocardial infarction are commenced on antithrombotic and secondary preventative therapies before undergoing invasive coronary angiography to determine the strategy of coronary revascularisation. However, this clinical pathway is imperfect and can lead to challenges in the diagnosis, management, and clinical outcomes of these patients. Computed tomography coronary angiography (CTCA) has increasingly been utilised in the setting of patients with suspected non-ST-segment elevation myocardial infarction, where it has an important role in avoiding unnecessary invasive coronary angiography and reducing downstream non-invasive functional testing for myocardial ischaemia. CTCA is an excellent gatekeeper for the cardiac catheterisation laboratory. In addition, CTCA provides complementary information for patients with myocardial infarction in the absence of obstructive coronary artery disease and highlights alternative or incidental diagnoses for those with cardiac troponin elevation. However, the routine application of CTCA has yet to demonstrate an impact on subsequent major adverse cardiovascular events. There are several ongoing studies evaluating CTCA and its associated technologies that will define and potentially expand its application in patients with suspected or diagnosed non-ST-segment elevation myocardial infarction. We here review the current evidence relating to the clinical application of CTCA in patients with non-ST-segment elevation myocardial infarction and highlight the areas where CTCA is likely to have an increasing important role and impact for our patients.
    MeSH term(s) Humans ; Coronary Angiography/methods ; Computed Tomography Angiography ; Myocardial Infarction/diagnostic imaging ; Coronary Artery Disease ; Electrocardiography ; Troponin/therapeutic use
    Chemical Substances Troponin
    Language English
    Publishing date 2022-09-20
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2982-8
    ISSN 1748-880X ; 0007-1285
    ISSN (online) 1748-880X
    ISSN 0007-1285
    DOI 10.1259/bjr.20220346
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  6. Article ; Online: Macrotroponin Complex as a Cause for Cardiac Troponin Increase after COVID-19 Vaccination and Infection.

    Bularga, Anda / Oskoui, Ellen / Fujisawa, Takeshi / Jenks, Sara / Sutherland, Rachel / Apple, Fred S / Hammarsten, Ola / Mills, Nicholas L

    Clinical chemistry

    2022  Volume 68, Issue 8, Page(s) 1015–1019

    MeSH term(s) COVID-19/prevention & control ; COVID-19 Vaccines/adverse effects ; Humans ; Troponin I ; Vaccination
    Chemical Substances COVID-19 Vaccines ; Troponin I
    Language English
    Publishing date 2022-07-27
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 80102-1
    ISSN 1530-8561 ; 0009-9147
    ISSN (online) 1530-8561
    ISSN 0009-9147
    DOI 10.1093/clinchem/hvac100
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  7. Article ; Online: Impact of Patient Selection on Performance of an Early Rule-Out Pathway for Myocardial Infarction: From Research to the Real World.

    Bularga, Anda / Lee, Kuan ken / Shah, Anoop S V / Anand, Atul / Chapman, Andrew R / Tuck, Chris / Newby, David E / Jenks, Sarah / Mills, Nicholas L / Kimenai, Dorien M

    Circulation

    2023  Volume 147, Issue 5, Page(s) 447–449

    MeSH term(s) Humans ; Patient Selection ; Myocardial Infarction/diagnosis ; Myocardial Infarction/therapy ; Acute Coronary Syndrome ; Biomarkers ; Troponin T ; Emergency Service, Hospital
    Chemical Substances Biomarkers ; Troponin T
    Language English
    Publishing date 2023-01-30
    Publishing country United States
    Document type Letter ; Research Support, Non-U.S. Gov't
    ZDB-ID 80099-5
    ISSN 1524-4539 ; 0009-7322 ; 0069-4193 ; 0065-8499
    ISSN (online) 1524-4539
    ISSN 0009-7322 ; 0069-4193 ; 0065-8499
    DOI 10.1161/CIRCULATIONAHA.122.062419
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: High-Sensitivity Cardiac Troponin Can Be an Ally in the Fight Against COVID-19

    Chapman, Andrew R. / Bularga, Anda / Mills, Nicholas L.

    Circulation

    2020  Volume 141, Issue 22, Page(s) 1733–1735

    Keywords Physiology (medical) ; Cardiology and Cardiovascular Medicine ; covid19
    Language English
    Publisher Ovid Technologies (Wolters Kluwer Health)
    Publishing country us
    Document type Article ; Online
    ZDB-ID 80099-5
    ISSN 1524-4539 ; 0009-7322 ; 0069-4193 ; 0065-8499
    ISSN (online) 1524-4539
    ISSN 0009-7322 ; 0069-4193 ; 0065-8499
    DOI 10.1161/circulationaha.120.047008
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  10. Article ; Online: Application of the Universal Definition of Myocardial Infarction in Clinical Practice in Scotland and Sweden.

    Taggart, Caelan / Roos, Andreas / Kadesjö, Erik / Anand, Atul / Li, Ziwen / Doudesis, Dimitrios / Lee, Kuan Ken / Bularga, Anda / Wereski, Ryan / Lowry, Matthew T H / Chapman, Andrew R / Ferry, Amy V / Shah, Anoop S V / Gard, Anton / Lindahl, Bertil / Edgren, Gustaf / Mills, Nicholas L / Kimenai, Dorien M

    JAMA network open

    2024  Volume 7, Issue 4, Page(s) e245853

    Abstract: Importance: Whether the diagnostic classifications proposed by the universal definition of myocardial infarction (MI) to identify type 1 MI due to atherothrombosis and type 2 MI due to myocardial oxygen supply-demand imbalance have been applied ... ...

    Abstract Importance: Whether the diagnostic classifications proposed by the universal definition of myocardial infarction (MI) to identify type 1 MI due to atherothrombosis and type 2 MI due to myocardial oxygen supply-demand imbalance have been applied consistently in clinical practice is unknown.
    Objective: To evaluate the application of the universal definition of MI in consecutive patients with possible MI across 2 health care systems.
    Design, setting, and participants: This cohort study used data from 2 prospective cohorts enrolling consecutive patients with possible MI in Scotland (2013-2016) and Sweden (2011-2014) to assess accuracy of clinical diagnosis of MI recorded in hospital records for patients with an adjudicated diagnosis of type 1 or type 2 MI. Data were analyzed from August 2022 to February 2023.
    Main outcomes and measures: The main outcome was the proportion of patients with a clinical diagnosis of MI recorded in the hospital records who had type 1 or type 2 MI, adjudicated by an independent panel according to the universal definition. Characteristics and risk of subsequent MI or cardiovascular death at 1 year were compared.
    Results: A total of 50 356 patients were assessed. The cohort from Scotland included 28 783 (15 562 men [54%]; mean [SD] age, 60 [17] years), and the cohort from Sweden included 21 573 (11 110 men [51%]; mean [SD] age, 56 [17] years) patients. In Scotland, a clinical diagnosis of MI was recorded in 2506 of 3187 patients with an adjudicated diagnosis of type 1 MI (79%) and 122 of 716 patients with an adjudicated diagnosis of type 2 MI (17%). Similar findings were observed in Sweden, with 970 of 1111 patients with adjudicated diagnosis of type 1 MI (87%) and 57 of 251 patients with adjudicated diagnosis of type 2 MI (23%) receiving a clinical diagnosis of MI. Patients with an adjudicated diagnosis of type 1 MI without a clinical diagnosis were more likely to be women (eg, 336 women [49%] vs 909 women [36%] in Scotland; P < .001) and older (mean [SD] age, 71 [14] v 67 [14] years in Scotland, P < .001) and, when adjusting for competing risk from noncardiovascular death, were at similar or increased risk of subsequent MI or cardiovascular death compared with patients with a clinical diagnosis of MI (eg, 29% vs 18% in Scotland; P < .001).
    Conclusions and relevance: In this cohort study, the universal definition of MI was not consistently applied in clinical practice, with a minority of patients with type 2 MI identified, and type 1 MI underrecognized in women and older persons, suggesting uncertainty remains regarding the diagnostic criteria or value of the classification.
    MeSH term(s) Male ; Humans ; Female ; Aged ; Aged, 80 and over ; Middle Aged ; Sweden/epidemiology ; Cohort Studies ; Prospective Studies ; Myocardial Infarction/diagnosis ; Myocardial Infarction/epidemiology ; Scotland/epidemiology
    Language English
    Publishing date 2024-04-01
    Publishing country United States
    Document type Journal Article
    ISSN 2574-3805
    ISSN (online) 2574-3805
    DOI 10.1001/jamanetworkopen.2024.5853
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